Individual
MARK E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 6TH AVE S, BIRMINGHAM, AL 35233-1601
(205) 279-2860
(205) 252-0197
Mailing address
PO BOX 2648, BIRMINGHAM, AL 35202-2648
(205) 558-2158
(205) 930-1575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15807
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000089050
—
AL
Enumeration date
06/28/2006
Last updated
05/22/2024
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